HomeMy WebLinkAbout040-1127-10-100 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
430409 0
GENER �L INFORMATION (ATTACH TO PERMIT) State Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No:
Hubert y, Raymond I Troy Township 040 - 1127 -10 -100
CST BM Elev: Insp. BM Elev: BM Desc /l dpti _- on :: /' / Section/Town /Range /Map No:
/ D, 0 IJ(J . yqj �� orn 07' /l0 "A 4 � 34.28.19.528A10
TANK INFORMATION ELEVATION A
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic - Benchmark
Dosing ,� I � Alt. BM
Aeration / V Vy � Bldg. Sewer
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic i� \ Z / Dt Bottom ' ,
Dosing / eader /Man. 3
Aeration Dist. Pipe
Holding Bot. System e (o.3 /• (7
ux P.bo
G
PUMP /SIPHON INFORMATION Final rade 2 .kd
Manufacturer Demand St Cover -7
GPM / hllll1 ha r) a• s �1$�
Model Number 0 5 — �-
TDH Lift Friction Loss System Head TDH Ft
' C)6 0 ,10 R- ! () ,
Forcemain TLen( j t h ! Dia. �� Dist. to Well
141 1 75
SOIL ABSORPTION SYSTEM
BED/TRENCH Width ! Length No. Of Trenches 6'4- r, PIT DIMENSIONS No. Of Pits Inside Di th
DIMENSIONS 5 0
fAl
SETBACK SYSTEM TO P/L JBILDG JWELL LAKE /STREAM LEACHING Manufacturer: _
INFORMATION CHAMBER OR
Type Of System: _ !l i UNIT Model Number:
TTII vYiL� G TZ ' bQ
DISTRIBUTION SYSTPEM PLO r D
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s) 'f 1
!
Length_ Dia_ I Lengtht j A Dia Spacing_
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over I Depth Over Topsoil x Depth of xx Seeded /Sodded xx Mulched
BedlTre h Ed es —
es o o
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: !s' // D3 EL
Location: 684 County MM Hudson, WI 54016 (NE 1/4 NE 1/4 34 T28N R19W) Unknown Lot ADvm Parcel No: 34.28.19.528A10
1.) Alt BM Description = fi -V
2.) Bldg sewer length
- amount of cover
c 3) 7 M 1 hole, h ✓ Lin�b! Ian revision Required? L•] Yes No
Use other side for additional information. _ ' _ i____ V
SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No.
ZOl W. Washington Ave., P.O. Box 7162 - Gje t) - - n lJ
IVIscoitsin Madison, WI 53707 - 7162 Site Address
De artm nt of Commerce ," /A-1 /A-I
Sanitary Permit Application, Sanitary Permit Number
In accord with Comm 8321. Wis. Adm. Code. peraa®al h6unation von wovide O Check if Revision Y D 9
L Application Information - Please Prim All Informatio State Plan I.D. N
PrQMV ° 711 Name SEP 1 6 2003 Parcel Number a4exlo- IIa >- a
1 Z 1� Ct,(�2 ���to ^ I/A
Owtxr ma"` /h/) ZONING OFFICE d„r� S
U �� ( •'A N R
City. State Zip Code Phone Number Lot Number ock Number
�-- ono
Subdivision N CSM Number
llu4es �•
a 93
U. Type of Building (check all that apply) OCity
Number of Bedrooms
1 or 2 Fatuity Dwelling – `-'/� �C� �2t!'f _-
OVillage
O Public/Commercial – Describe Use ownsbi Q
O State Owned ,�,LQ7/ . (N Nearest Road
nn
III. Type of Permit. (Check only one box online A (numbering scheme for internal use). Complete line B if applicable)
A. 1 O New 2JE1 Replacement System 3 11 Replacement of 6 O 'Addition to For County use ..
Sy stem I Tarok Only I Existing System
B. 0 Check if Sanitary Permit Previously Issued Permit Number Date Issued
IV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) i el S 3 X 7t $ ' 6 at n t' y`4��1C
4420 Non – round 210 Mound 47 0 Sand Filter 50 O Constructed Wetlaw / S �4 �� �'� n
22 Pressurized In- Ground 410 Holding Tank 48 ❑ Single Pass 510 Drip Line 3 - ? ZC� ( / i
45 0 At -Grade 46 0 Aerobic Treatment U ' 49 0 Recirculating 30 O O r ✓
V. DispersalMeatment Area Information: Le4,rA Yt
Design Now (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Bleva ion Firm Grade
Required '4 Proposed Rate(Gals./Days/Sq.Ft.) (Min.Mch) Oh, >a s Elevation
VI. Tank Info Capacity in Total Number Manufacturer Prefab f Site Steel Fiber Plastic
Gallons Gallons of Tanks Concrete Constructed Glass
New 8xb tns
Tanks T
Septic or Holding Tank
Dosing Chamber
VII. RaTonsibili Statement– 4 the undersigned, assume responsibWty for POWTS shown on the attached plans.
rs Name (Print) Pl igmature RS r Business Phone Number
Plumbers Address (Street. City. S Zip Code)
W ) � "/ A �l
VIII. IDe artment Use Only
Approved ❑ Disapproved ��y� Permit Fee (includes Groundwater Date Issued igoadue )
Surcharge Fee
O Owner Given Imi ial Adverse
DeWmirndon
M Conditions of Approval/Reasons for Disapprovai Lq �eC • 3 f y/S tin * -P�.
STEM OWNER:
1 Septic tank, effluent filter and
dispersal tell Must 211 be mStaiapd as per management plan OObl �
°O` weI=tb'ns�rt =311a�si
2. All setback requirements must be maintained
39& (ftb *S1 j)0rdtn
I1 2 J 1I: v. i 1 11 b42bboba WEGEREf �DWL I LSl DAU h-AuE �
'n J PLOT PLAN Pave of
Scale . } = yD ° -- —
y Y
I� I
3 n 37 �' ` 6 units
3 0 101,
�. T6
I
160• � a � � �--- � i
9 N /O s
L� a• - \�U3 715--42 -0165 220254
CST Signature Date Telephone No. CST Yo. Job mo.
'.112bU3 12: -i l 17154156864 WEGERER SOIL TESTING PAGE 03
PLOT PLAT Page of -�
GAOi1 dYW e Y Scalp 1' =Y)
�
1 0 0
n 37 ld uni tS
s Milt;
L 3 p �0 �A-
y
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a� lew-- 6� o Cpht �. f J a
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6 � +
C
9� 1610
715 -- 425 -0165 22025
CST Signature Date Telephone 1To. CST No. Job '10.
PAGE OF
PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS
VENT CAP
H "C.I. VENT PIPE
WEATHER PROOF APPROVED LOCKIN
2S' FROM DOOR,
JULICTIOM BOX MANHOLE COVER W
� " I.Iytir/�il1 "� »CtbT/
WINDOW OR FRESH IZ MILL.
AIR INTAKE
GRADE —
I `i" MtN.
— IB-MIL1.
CONDUIT
PROVIDE I - - - --
INLE T AIRTIGHT SEAL
t i I
APPROVED JOINT A I I APPROVED JOINTS
W /C.I. PIPE l (I I W /GI. PIPE
EXTEMI)IN4 3' I II ALARM EXTENDINb 3'
OUTO SOLID SOIL B I i I ONTO SOLID SOIL
I
I I ON
C i
LLEV. __ FT. j
u
PUMP —� OFF
0
CONCRETE BLOCK
/� /0 .. PR
RISER EXIT PERMITTED Ly IFTANK MANUFACTURCR HAS SUCH APPROVAL gg� 4
SEPTIC MSPE C.IFICATIOUS
DOSE „
TANKS MAIJUFACTURER: S °'Wr 0s LL�f'� o� e�e NUMBER OF DOSES: PER DAU
TANK 51ZC: -r- GALLONS DOSE VOLUME / �,
ALARM MAUUFACTURLR: ,d INCLUDING BACKFLOW: �L � a GALLONS
MOD6t, 1.1UM6CR: CAPACITIES: A= �� INCHES OR' 53..E GALLONS
SWITCH TYPE: - h . u r I t g = , _ INCHES OR � GALLONS
PUMP' MAWUFACTURCR: &0Lj 1 ! C= �� p � }} INCHES OR 1 • GALLOWS
MODEL NUMBER: YA9/ D =.L3csLINCWESOR GALLONS
- SWITCH T`JPE: , MOTE: PUMP AND ALARM ARE TO BE /Zoo
MINIMUM DISC14ARGE RATE 1 2 _.GPM INSTALLED ON SEPARATE CIRCUITS
VERTICAL- DIFFEREMCE BETWCCN PUMP OFF ANO pISTRIbUTION PIPE.. FEET (0 IDS
♦ MINIMUM NETWORK SUPPLY PRESSURE ... . . .. .. .. 2 . 5 FEET - 2,6O
♦ 90 ' 1 EET OF FORCE MAIN X 0 1K F Y, FL FRICTIO N FACTOR FEET U " �
TOTAL Dy1J04IC. HEAD = X3.39 FEET g ?
IMTERNAL DIMENSIONS OF TANK: LEWGTH ;WIDTH *LIQUID DEPTH
SIGNED: LICEWSE MUMBER: D
?.;.�
Goulds
Submersible
Effluent Pump
L
3871 EPO4
EP05
APPUCATIONS • Fasteners: 300 series • Fully submerged in high ■ 1111dw Housing: Cast iron
Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer,
• Capable of running _ lubrication and efficient strength, and durability.
• Eer fM it uses: dry without damage to heat ttar of
• fttt systems ■ Nlo1w Corer: Thermoplas-
• Homes components' tic cover with integral handle
•
Farms mote. Available Mr automatic and and float switch attachment
• Heavy • EPO4 Singhase: 0.4 HP, manual operation. Automatic per•
• Water t fer�� 115 o 2301V, 60 H7,1550 models w S reeds w� assembled mbled cal 0 Power Cable: Swm d
• � RPM, built in overload with Float amt rated oil and water rest
autarratic reset. p at !M factory.
SPECIFICATNIRS • EP05 Single phase: 0.5 HP, ■ + and lower
115 V, 60 Hz, 1550 RPM, FEATURES heavy duly ball bearing
Pump: EPO4 built in overload with construction
reset. ■ EPO4 Impeller. Thermo-
• Solids �ilnY plastic Semi -open design
3 /: maximum. • Power cord: 10 foot with pump out vanes for AGENCY USTING
• Capacities: up to 55 GPM. standard length. SJTO mechanical seat protection. s Jl�ocialian Co • Total heads: up to 24 feet with three prong grounding
• Discharge size: 1 NPT. plug. Optional 20 foot • EP05 Impeller. Thermo -
plastic enclosed design for (CSA listed model numbers
• Mechanical seal: carbon- length, 1613 SJTW with improved performance. end in r or "AC".)
rotary/ceramic - station ty, three prong grounding plug
BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged
• Temperature: thermoplastic design provides
104•F (40•C) continuous superior strength and
140•F (60•C) intermittent corrosion resistance.
• Fasteners: 300 series METERS FEET
stainless steel. 10
• Capable of running
dry without damage to s -- - - - --
p ui — ►{scar i
Pump EP05
• Solids handling capability: o 2s i
Vi maximum. W
• Capacities: up to 60 GPM. s
• Total hem up to 31 feet.
• Discharge sim. f W NPT. z 5
• Mechanical seal: carbon- �-
rotary /ceramic - stationary, ° a 15
BUNA -N elastomers. epos
o
• Temperature: 3 10
104•F 40•C continuous ( ) t
140°F (60•C) atermfiteM. 2
� I o o
0 10 20 30 40 so GPM
0 2 4 6 8 10 12 m�lh
`� ••�►: System Management Plan
Pu to Comm 83.54, Nis.Adm. Code
Sectic Tank
The septic tank - be maintained by an individual certified to service septic tacks under s. 281.48, Slats. The contents of the
septic tank shaA be disposed of in accd rdance with NR 113. Wis. Adm. Code. The operating condition of the septic tank and
outlet fitter shag be assessed at least once every 3 years by inspection. i ne outlet filter S, awl be Geared as necessary to
ensure Proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that
may slough off the filter when removed from its encicsure. If the fitter is equipped with an a►' .. the fiiter shag be serviced if
the alarm is actuated continuously. in filter alarms may indicate surge flows or an impending continuous alarm. The
septic tank shag have contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of
the tank p the contents of the tank are not removed at the time of a triennia! assessment, Rmi ntenance
the'owner of when the next service needs to be performed to maintain less than maximum sr.,rm and Pit steep advise
the tank The WOW of biokagkcol or chemical additives to enhance septic tank pedb nnance is err �e ac^� re.. in
H re
However, if such products a used thej shag be g guy not required.
gudding's Division. approved for septic tank use by the Department of Commerce. Safety and
Puma Tank
The Pump ( dosing) tank shag be inspected at least once every 3 years. AD switches, alarms, and pumps shag be teed to
! Y Proem' % n. If an effluent tfiter is installed within the tank k shag be inspected and serviced as necessary.
At- rade Component and Pressure Distribution S stem
o.trees.or shru s s Oulu be planted or allowed to grow on the component. Plantings may
be made around the perimeter and the component shall be seeded and mulched as necessary
to prevent erosion and to provide some protection from frost penetration. Traffic (other
than for vegetative maintenance) on the component is not allowed. Cold weather install-
ations require the component to be heavily mulched for frost protection.
Influent quality into the at -grade system may not exceed 220mg /L BODS, 150 mg /L TSS and
30 mg /L FOG. Influent flow map not exceed the maaimiim design flow specified in the permit
for this installation.
The pressure distribution s ystem I prov ided wdh a Wing point at the end of each lateral, and it is M=mwnded that each
=mWed to the i test when the at � once every 18 months. When a pressure test is performed d should be
t& e9� dstn'butio � was wed m determi g orifice dogging has ocarrred and fi office cleaning is
dispersal keg. .
Observation pipes within the dispersal cell shall be for effluent ponding.
Ponding levels should be reported to the owner and any levels above 4 inches considered'
as an impending hydraulic failure requiring additional, more frequent monitoring in
accordance with Comm 83.52 (2).
General
his system shall be operated i accordance with Comm '82-84 Wis.Adm.Code and shall be
maintained in accordance with it!s component manual SBD 10 570 - P•(8.6 /99) and
state rules pertaining to system maintenance and maintenance reporting..
No one should PUMP tank abardonn� shd be in PAP tank since dangerous gases may be present that could cause death. Septic and
FOWTS �Ponentg. accordance write Comm 83.33, Wits. Adm. Code when the tanks are no Io ger used as
Septic or pump tank manhole risers
opts used for , access risers and covers should be inspected for water tightness and soundness. Access
unsound, service and assessment shag be sealed watertight upon the completion of service. •Arty opening deemed
be 80 =ffW by an eWAft. or subject to failure must be replaced, Exposed access openings greater than 8 -;ncoes in diameter shag
effec5ve k ing device ifl prevent acddenha! or nunauifiorizid entry into a tank or c drnponent
MY of Its =nPomb become defertitve the tank or component shd be - or to �
PtOP� ° condition. repaired repitd keep The
tink PMP. Pump COnftOls, alarm or related � becomes defk* the defective coniponurnt shd be .
1' or replaced w a neat of the same or equal perkmnance.
If the at -grade componeat'fails to accept aastevatisr'or"ib'eRias - to disc rite wastter to
the f=ound surface, it may be necessary to install as aerobi pre - treatment gait or ewa
ations may need to be done -and
addl aonal plans may to be prepared and app*oved by the Department of Conmerce,•
Safety and Buildings Division. .
Questions
out the operation or maintenance of this system shoulcl'be directed tots
- The County Zoning Office at 'Z �S _ Z� 3- 6 1�L `� -�j , �f'Q�X 38'6 �� g o
The sys tea installer at 1 LS - L 2S - Q q SR_
The tank manufacturer at
The effluent filter' manufacturer at - ZZ1- S7((Z, Z, tXL
v
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer
Mailing Address
Property Address e 4 r""efi
(Verification required from Planning Department for new cons ction)
! Pow ➢ - -006
Cit (U �'t A U`� ( Parcel Identification Number tea- 116�U`l�a'-3UbDl� tY - o �
LEGAL DESCRIPTION V0 12 " /D - O , � G
� n
Property Location L E V., V,, Sec. , T / N -R-1—W, Town of
Subdivision . Lot #
Volume Page #
r J . Volume r Page #
Spec house ❑ yes f�no Lot lines identifiable yes ❑ no
SYSTEM MAINTENANCE
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system
can affect the function of the septic tank as a treatment stage in the waste disposal system.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
masterplumber, joumeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system
is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards
set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
days of the three year expiration date.
/3v1�
SIGNA OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owners) of
the rty described above, by virtue of a warranty deed recorded in Register of Deeds Office.
SIG OF APPLICANT DATE
* * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * **
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
1 s in accordance with Co
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must C¢unty Ste• C �� �x
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location an J dista&E F6 ri aigstl"l U — Z 1 () 1 D O O
Please print all information. R iewed by Date
Personal information you provide maybe used for secondary purposes( rivacy LAC& ?"4 f:
Property Owner Property Location ) Z
Gov Lot 13 N R E (or) W
Property Owner's Mailing Address Lot # Block # Subd. Nam rr #
City State Zi Code Phone Number tuber
City Village wn
_ ❑ ❑ 9 � Barest Road
21.0 r , ^ "
�t� w,► s �,� ` (� f S) �
4 �.S _Q3 0`� 1 1 W
❑ New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate GPD
23 Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable
General comments C4?"1.� S ; �' 1`' - ' xl ` b i.vtrJ� w U'jCT� Or- ��F ��'.)
and recommendations�`� L r�
LU hJ w b 1 J �l 3 0 F i iU �1 L�l�
❑ Boring # ❑ Boring
® Pit Ground surface elev. n, S - - 7 ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I •Eff#2
4 -lS 10"11231 Z CG, -j -
Z 's
102 .
'
bq _��3 10 2 st _
6 �^ 'S' C5
s � `Z.. � � i_ l WL�s itilty r'y2.y't - � ; ���5 7
Boring # ❑ Boring
El pit Ground surface Bleu. � 8 ' S ft. Depth to limiting factor 7 )) 7 in.
Soil Appliption Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
D -lZ 10`1.2 31 Z -• S l l Z`1�S b 1Z M�r` � �. `c � S � �
3 Z.q wl2 V/6 b Yl')9 e_
T �
� 1 ►�1 I
Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg1L
CST Name (Please Print) Sig tore CST Number
Arthur L Wegerer a" Vd - 0 3 -13 220254
Address W e g e r e r Soil T e s t i n & Design S e r v i c e Date Evaluation Conducted Telephone Number
C. 421 N. Nain St. River Falls, WI 54022 `�- � �u3 715 -425 -0165
Property Owner ' I v $- Parcel ID # `I l 1 Z1 - I o - 10 O Page of
Boring # ❑ Boring
3 ® Pit Ground surface elev. �' ft. Depth to limiting factor 1 ! (° in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots , GPD /ft
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
D - \`Z Q -31 S I
!, l Z`�'s�1 -� `M CL,-" 1-� I • s , g
2 1z -Zs — si s Z�'sb� C-l'i ,5
3 zs -6 S lD`4rz V16 — s rn v CS — • �(
I Z S
F-1 Boring # ❑ Boring
pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizor� _ Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
In. - Munsell Qu. Sr. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2
F-1 Boring # ❑ Boring
❑ Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft'
In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
r .
r
Effluent #1 = SOD > 30 < 220 mg /L and TSS >30 < 150 mg /L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 - 8777.
S1113-8770 (R.6/00)
PLOT PLAN Paae 3 of 3
Scale
q�
U 0 0
�8
• J
via\ - t
i
P� C71Z. g
co v"\f •
C\) J_'
715-425-0165 5 •1G5 22254
CST Signature Date Telephone No. CST No. Job NO
i
GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01
REAL ESTATE TOWN OF TROY - - -- —�
COMPUTER NUMBER 040 - 1127 -10 -100 Parcel Num r 34.28.19.528A -10
Claimed Date Re- certified / / Relate Number:
OWNER NAME: First RAYMOND B & JANITH Last HUBERTY
CO -OWNER
Mailing Address 684 CTY RD MM
City RIVER FALLS State WI Zip 54022 -
Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date
HISTORY QC 1536/ 378 628577 08/22/2000 /
PROPERTY ADDRESS:
Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office
684 CTY RD MM
School District: 4893 - SCH D OF RIVER FALLS
Special District: (1) 100 - (2) - (3) -
CHIP VALLEY VOTECH
Plat Code: Last Changed on: 10/08/2001 Book Number: 1
SECTION 34 TOWN 28N RANGE 19W '/4160 1 /440 Map Number: 00 - Sales Area:
Parcel Control 0 TAXABLE
Number of Units:
ZONING: Permit Number: Type:
Bank Numbers:
F4 -Prev, F5 -Next, F6- Legal, F7- Value, F8- History, F10 -Exit, F12 -More
I
LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02
REAL ESTATE TOWN OF TROY
COMPUTER NUMBER 040 - 1127 -10 -000 Parcel Numb 34.28.19.528A ' 5 A
OWNER NAME: First RAYMOND B & JANITH Last HUB
PROPERTY e # 1 eet Name -- Type SD Apartment
4 CTY RD MM
SECTION 34 TOWN 2 AN to . 60 '/.40
Line Description Line Description
TOTAL ACREAGE 1.100 PLAT LOT BLK
01 SEC 34 T28N R19W PT NE NE 15
02 COM 1000 FT W OF NE COR, TH 16
03 N 6 DEG E 12 FT, W 267 FT, S 17
04 1 DEG W 154.3 FT, S 64 DEG E 18
05 179.9 FT, TH N 47 DEG E 19
06 128.6 FT, N 6 DEG E 133.7 FT 20
07 TO POB INCLUDES 431A 21
08 22
09 23
10 24
11 25
12 26
13 27
14 28
F1- General, F4 -Prev. Parcel, F5 -Next Parcel, F7- Valuations, F8- History, F10 -Exit
sURv EY 4SkH16 /T A ..
. MAP of
Philip J. and Patricia
s� F �j � rt*en
a�_ 1536 38
l,F_t;FNI)
IKSr LINO Sr //4 -!E t/4 SEC. 27!
t rAsr LINE S W //4 - O f 114 SEC. 27i h,ican 1 of 24" b" p}e so.
p (Mt. ft - 1.1 t lIw46L A)
S 89 /9'4/ "E 593.7l, • Jc+rlrs 1" Mrwr}tJtiwnl
(it ABe onW
O (R N peso 4'� "E� B9 �.+•i
(R+ WEST) " t ?. p; T (#z WEST /OQCLO
N 89 Y3 W 67. t _ -- N19 ° /9��(" W /0037.9
- Q SOUTr/ LINE SE 114 SEC. 27
SOUTH I14 COR. SEC. 27 /NORTML /NE NE 114 SEC, 34) + SE CORN ERC EC. 2.
/NORTH/ /4 CO SEC.34 / f SE 34)
T2BN, R /IW
R/IIY
(COUNTY ,ONUM r) ^� ` ^ /COUN7 MONUMENT:
rj
r
WEST LINE NEI 14 -NE 114 $10. 54 ►�- i G•
/EAST L /NE NW I14 - ME 114 SEC. 34)
/' ,�IIIIIIINp�
cY/wE DA Ed � \SCONS
C xrve 1 - 2 1taiNue • 71421' S` . � ••...........••• %/ ko s f IN FEET t „"100
Cewfirff • 1T 4!' K”
CAanl 592' N" N', 17,f6' _' LAURENCE B so
S M W M U R P Y: BEAR /NOS ARE REFERENCIV rO THE SOUTH
LINE OF THE SE I14 OF SECTION 27, ASSUMED
• S �+ 4 BEAR /NB MSRO '4I"W.
�- R FALLS,,: � ,� •
RarAW • 749.21'
WISC. •.� Q �
C'ex&W Angir -Iii' 13 K" ,�i qF • • • • $ ��
C hard - .S' 14' 47' 43" W, K f1' ,,,e a ,A N 0 �
I1M SCNZPIWN
A parcel of lard located in the Southeast 1/4 Qf the Sow ast 114 and the Sowthwrs! 114 of the Southeast 114 of
Section 27, and In the Northeast 1. of the Northeast 1, '4 and the Northwest 114 of the Northeast 114 of Section 34,
all in Township 28 North, Range 19 West, Town of Trrv, St Croix Cowntv, W isconsin, Wrote particularly described
crs follows: Commencing at the Southeast corner of sald .Section 27; thence N 89 W (asswmed bearing on
the South line of the Southeast 114 of said Section 27, recorded as West), 1003.79' (recorded as 1000') to the Point
gJ'ReRinning of the parcel to be herein described; thence N 06'34' 44" l;', 8.92' (recorded as N 06" 12'E, 12.0);
thence N 89' 43'2,5 " W (recorded as !Pest), 267 00'; thence S 02 " iV (recorded as S 01'.56' W), 134.30';
thence N 63 if'', 56.31, thence N 02 05 18 " {i; 198.30',- thence S 891 19'41 „ h.', 393.79', thence
,S 02 W / 99.013' to a point in the centerline of C. T.H. "MAT'; thence, along .said centerline, a curved line,
concave la the Southeast, having a radius of 71620; whose chord bears S.52 04" W, 97.66; thence
N 06'34'44" F' (reeorrkd as N WIVE 18 5.33' to the Point of Beginning, containing 44,926 square feet or
1.031 acres, being subject to an easement, for C, T. H. "AA " wmr tJw SowiMeasterly 33.00' thereof, and any abler
easements of record.
This parcel is intended to be an add on parcel and an affadrtvit must be recorded attaching these lands to
the exi,sting parcel as required by S1. Croix County.
,S'tate o H'ixonsfn)
County of fi erce) � / g o
1, Lawrence W. Murphy, Registeled Land Surveyor, do hereby certify that i have surveyed the above
ckscrfbed and mapped property according to official records and that this map and description are
a true and cdxrect represgntadon J*ereof.
MIIJIUE 1A1W X 72 YWr7 ` -9/0
XZV= FAIL J, ` / "= i00'
MWP
TIGN v 1
Il'.raooe�es� �. A�Itma
7IlSr4��s Y?4 .� -ss -,9
I 99- l43
voi.1536PAGc 379
Affidavit, Part 2
The parcel shown on this document is being added to the
parcel shown on the document recorded in Vol. Page
,LL, Document No. described as a parcel of
land located e B
to create one parcel, and
this transaction is thereby exempt from Chapter 18 of the
St. Croix County Land Use Regulations pursuant to Section
18.05 (A) (3) .
A parcel of land located in the"
Nortneast Quarter of the Northeast Quarter -
(NB %NE %) of Section Thirty -Four (34), and the
Southeast Quarter of the Southeast Quarter I I
(SEhSEh) of Section Twenty- Seven(27), Township
Twenty -eight (28) North, Range Nineteen (19) West, further described as
follows: Beginning at a point on the North line of said Section 34 a
distance of 1000.0 feet West of the Northeast corner of said Section 34.
thence North 6 0 12' East a distance of 12.0 feet, thence due West parallel'
with said North line a distance of 267.0 feet, thence South 1 °56' West
a distance of 154.3 feet, thence South 64 0 21' East a distance of 179.9
feet,thence North 47 °10' East along C.T. "M -M" a distance of 128.6 feet,
thence North 6 0 12' Last a distance cf 133.7 feet to the point of beginning.
Containing 1.1 acres, more or le ss. I
1`1
Y01'.1536PAGE378 .
I STATE BAR OF WISCONSIN FORM 3 - 1998 6245 - 7
QUIT CLAIM DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
Document Number
r I
RECEIVED FOR RECORD
PH /� a AID P/4T/�/C /A
This Deed, made between r 48-22 -2000 14:00 AM
FE FeF /S 1/
QUIT CLAIM DEED
Grantor EXEMPT R
CERT COPY FEE:
and A2A YMn AID B 74 S� h COPY FEE:
TRANSFER FEE: 12.60
Al / 9)Z 7 % PAGES: FEE: 34.00
./ 2 ivNr TEJ 4A5TS Grantee.
Grantor quit claims to Grantee the following described real estate to is
S T C R04& .County, State of Wisconsin:
Recording Area
Name and Return Address
PP, - qo= oab
fkd 0qO- /1 -3 0 -e
Parcel Identification Number (PIN)
This /S POT homestead property.
(is) (is not)
p�lcr 41441 -/r 2'7 - 20 -oav
P40T p�co— r2 7 - 3a —pDD
D yo- 1 107 -'70 -000
ooO- 1127 — 1 D - D c il
I..
1'
Together with all appurtenant rights, title and interests.
Dated this day of cc O •
it
C'
(SEAL) (SEAL)
1
(SEAL) (SEAL) 1
AUTHENTICATION ACKNOWLEDGMENT
Signatures) State of Wisconsin,
ss.
S CROIX County.
authenticated this day of Personally came before me this 22ND day of
AUGUST 2000 , the above named
PHILIP J FEYEREISEN AND PATRICIA FEYEREIS
*
TITLE: MEMBER STATE BAR OF WISCONSIN to
Of not, me known to be the person S who executed the foregoing
authorized by §706.06, Wis. Stats.) instrument and acknowledge the same.
THIS INSTRUMENT WAS DRAFTED BY
PAULETTE ORF
�►1'� OGZ•.��
Notary Public, State of Wisconsin "ll :
My commission is permanent. (6 6 mb date:
(Signatures may be authenticated or acknowledged. Both are not JAN )
/k
necessary.) fir•••• .
* Names of persons signing in any capacity must be typed or printed below their signature.
STATE BAR OF WISCONSIN Wisconsin Legal Blank Go., Inc.
QUIT CLAIM DEED FORM No. 3 - 1998 Milwaukee, Wis.